The challenges of leading change in health-care delivery from the front-line

Byers, Vivienne

doi:10.1111/jonm.12342

Cited by 35 publications

(35 citation statements)

References 35 publications

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“…In this instance, committed practitioners assumed responsibility for implementing important changes, covering the decisions associated with this informally and collectively as they balanced the demands on their time and expertise. The more recent research in this review demonstrates that this pattern (Cleary et al, 2011;Fulop, 2012;Haycock-Stuart and Kean, 2013;Chreim et al, 2013;Byres, 2015).…”

Section: Figure 1 Search Results and Selection Processmentioning

confidence: 99%

“…For some commentators, these outcomes are strong enough to secure a fundamental shift towards distributed leadership (Tomlinson, 2012: 31;Byres, 2015). Ostensibly, it offers an effective means of delivering improvements, restoring public confidence and satisfying regulatory concerns and is therefore likely to attract wider recognition and support.…”

Section: Figure 1 Search Results and Selection Processmentioning

confidence: 99%

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The reforming appeal of distributed leadership

Beirne

2017

British Journal of Healthcare Management

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With a systematic literature review, this article examines the significance of distributed leadership in health care, assessing the extent to which it reflects a consistent set of values, meanings, practices and outcomes. It identifies key mediating factors and their importance in enabling or constraining distributive leadership processes. The findings indicate that clinicians without formal leadership titles are inspiring change and driving improvements, although countervailing pressures are limiting this in practice. Distributed leadership is evident in the way that clinical teams function, and more could be made of this for the modernization of health care. At present this potential tends to be constrained, and subject to competing interpretations that reflect distinct occupational identities. Greater attention could be given to educational and developmental programmes that claim space for distributed influence among current and aspiring leaders, and for enabling arrangements that can help 'ordinary leaders' to feel less vulnerable and more confident about this aspect of their practice. Established approaches to leader development could be usefully refocused to prioritize collective processes and refine relational abilities, ideally with more inclusive, joint venture initiatives that bring formal and informal leaders together for mutual learning and effective engagement.

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Section: Figure 1 Search Results and Selection Processmentioning

confidence: 99%

Section: Figure 1 Search Results and Selection Processmentioning

confidence: 99%

The reforming appeal of distributed leadership

Beirne

2017

British Journal of Healthcare Management

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“…Such practice may promote the goals of all nutritional care for older persons in long‐term care settings (e.g. to improve food intake and nutritional status, as well as independent living) .…”

Section: Introductionmentioning

confidence: 99%

Hospital nurses and home care providers’ experiences of participation in nutritional care among older persons and their family caregivers: a qualitative study

Hestevik

Molin

Bergland

et al. 2019

J Human Nutrition Diet

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Background A person‐centred approach to nutritional care has the potential to increase an older person’s role in making informed decisions about their own care and possibly improving their quality of life. However, despite the considerable interest shown in person‐centred nutritional care in recent years, delivery of such care still appears to lack consideration for older persons’ needs and preferences. The present study aimed to explore healthcare professionals’ views on how older persons and their family caregivers participate in decisions about their own nutritional care and possible barriers for that participation. Methods Semi‐structured in‐depth interviews with 23 healthcare professionals in acute geriatric care and home care were conducted. Data were analysed thematically. Results The analysis of the interviews resulted in three main themes: (i) lack of shared decision‐making in nutritional care; (ii) conflict between patient’s preferences and standard nutritional care procedures; and (iii) the value of family caregivers who are seldom involved in nutritional care. Conclusions Healthcare professionals were aware of the importance of actively engaging older persons and their family members in the nutritional care to achieve positive outcomes. However, they encountered individual and structural barriers, including resistance from patients and family caregivers, conflicts between the patients’ nutritional wishes and standard nutritional procedures, a wish to shield the family caregivers from the stress of caring for a sick relative, and lack of time and caring structures that facilitate the older persons and their family’s active participation.

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“…Recurring patient safety problems in Irish healthcare have led to a growing interest in helping hospitals and their governing bodies to provide more effective oversight of the quality and safety of their services by defining priorities and objectives and shaping their culture (Darker, 2014). Although Irish health policy pushes the concept of person-centred care, to date, the structures and processes of care delivery have not been changed sufficiently to accommodate this alteration nationally (Byers, 2015). Darker (2014) affirms that, at board level, hospitals need to endorse a commitment to personcentred care and oversee the strategies required to ensure the rights and involvement of patients.…”

Section: Conclusion -Implications For Practice and Ongoing Researchmentioning

confidence: 99%

The Patient Survey Programme: Transforming the patient experience in Irish healthcare

et al. 2017

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The challenges of leading change in health-care delivery from the front-line

Abstract: Health services tend to be over-managed and under-led and there is a need to harness the potential of front-line nurses by facilitating leadership development through appropriate organisational support.

Cited by 35 publications

References 35 publications

The reforming appeal of distributed leadership

The reforming appeal of distributed leadership

Hospital nurses and home care providers’ experiences of participation in nutritional care among older persons and their family caregivers: a qualitative study

The Patient Survey Programme: Transforming the patient experience in Irish healthcare

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